Summary & Overview
HCPCS C9444: Oritavancin Injection, 10 mg
HCPCS Level II code C9444 identifies a 10 mg unit of oritavancin administered by injection, an intravenous antimicrobial used in the treatment of serious Gram-positive bacterial infections. This code matters nationally because oritavancin is a single-agent, long-acting lipoglycopeptide with high acquisition cost per dose and specific administration considerations; accurate coding affects claims processing, payer coverage determinations, and facility billing for infusion services. Key payers covered in this overview include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will learn what C9444 denotes clinically and operationally, the typical sites of service where it is administered, and which payers are included in the analysis. The publication summarizes benchmarking and coverage context, highlights coding and billing implications for infusion of high-cost antimicrobials, and outlines items readers should expect to find in payer policies and reimbursement guides. Where input data are not provided, the summary notes that specific payer policy details, modifiers, taxonomies, related ICD-10 diagnoses, and service line data are not available in the input.
Billing Code Overview
HCPCS Level II code C9444 represents injection, oritavancin, 10 mg. The service type is intravenous antimicrobial administration. The typical site of service is acute care or outpatient infusion settings, including hospital outpatient departments and infusion centers.
Data not available in the input.
Clinical & Coding Specifications
Clinical Context
A typical patient is an adult presenting to an outpatient infusion center or hospital outpatient department with a confirmed acute bacterial skin and skin structure infection (ABSSSI) or complicated Gram-positive bacteremia caused by susceptible organisms (for example, methicillin-resistant Staphylococcus aureus). The patient has an established IV access and requires a single-dose, long-acting intravenous antibiotic. The clinical workflow includes diagnosis and documentation of the infection, review of culture and susceptibility data when available, informed consent for IV antibiotic therapy, preparation and administration of C9444 (injection, oritavancin, 10 mg) by an infusion nurse or pharmacist, observation for infusion-related reactions during and after administration (typically 3 hours of monitoring for initial safety parameters), and documentation of lot number, dose, route, time, and any immediate adverse events in the medical record. Billing for the medication uses HCPCS level II code C9444 per 10 mg increment; the clinician documents the indication, total milligrams administered, and any associated services (evaluation, infusion supplies, monitoring) needed for correct claim submission.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
25 | Significant, separately identifiable evaluation and management (E/M) service on the same day |